Primordial

Until emergency help arrives, a victim of outdoor hypothermia should be brought to shelter and warmed by:

removing wet clothing and footwear,

drying the skin, and

wrapping him or her in warm blankets or a sleeping bag.

Gentle handling is necessary when moving the victim to avoid disturbing the heart.

Rubbing the skin or giving the victim alcohol can be harmful.

Warm drinks such as clear soup and tea are recommended for those who can swallow.

Anyone who aids a victim of hypothermia should also look for signs of frostbite and be aware that attempting to rewarm a frostbitten area of the body before emergency help arrives can be extremely dangerous. For this reason, frostbitten areas must be kept away from heat sources such as campfires and car heaters.

Rewarming is the essence of hospital treatment for hypothermia.

How rewarming proceeds depends on the body temperature.

Other considerations, such as the patient’s age or the condition of the heart, can influence treatment choices.

Different approaches are used for patients who are:

mildly hypothermic (the patient’s body temperature is 90–95°F [32.2–35°C]),

moderately hypothermic (86–90°F [30–32.2°C]), or

severely hypothermic (less than 86°F [30°C]).

Mild Hypothermia

Reversed with passive rewarming.

This technique relies on the patient’s own metabolism to rewarm the body.

Once wet clothing is removed and the skin is dried, the patient is covered with blankets and placed in a warmroom.

The goal is to raise the patient’s temperature by 0.9–3.6°F (0.5–2°C) an hour.

Moderate Hypothermia

Often treated first with active external rewarming and then with passive rewarming.

Active external rewarming - applying heat to the skin (e.g., by placing the patient in a warm bath or wrapping the patient in electric heating blankets).

Severe Hypothermia

Requires active internal rewarming, which is recommended for some cases of moderate hypothermia as well.

There are several types of active internal rewarming:

Cardiopulmonary bypass - the patient’s blood is circulated through a rewarming device and then returned to the body, is considered the best, and can raise body temperature by 1.8–3.6°F (1–2°C) every 3–5 minutes. However, many hospitals are not equipped to offer this treatment. The alternative is to:

Introduce warm oxygen or fluids into the body.

Hypothermia treatment can also include, among other things:

insulin,

antibiotics, and

fluid replacement therapy.

When the heart has stopped, both cardiopulmonary resuscitation (CPR) and rewarming are necessary. Once a patient’s condition has stabilized, he or she may need treatment for an underlying problem such as alcoholism or thyroid disease.